Harbor Health, other plans expect Medicaid numbers boost

Detroit Medical Center's Harbor Health Plan Inc., the newly minted name of the former ProCare Health Plan, expects to increase its membership to 18,000 this year, up from 3,300 currently, primarily as the state expands Medicaid this spring and nearly 100,000 people with incomes below 133 percent of the federal poverty level begin to enroll in Wayne County.

"When we bought ProCare in (October) 2012 (for $6 million), we felt at DMC that we wanted to have a new brand name for a fresh start," said Greg Berger, M.D., Harbor's chief medical officer.

Berger said DMC's own name has helped Harbor Health increase membership the past year to 3,300 from 1,900 members. Harbor Health is only licensed in Wayne County.

Harbor Health this week plans to begin a marketing and advertising campaign that primarily will be on radio and cable television, said Sarah Collica, DMC's press secretary.

Nearly 100,000 of the state's expected 470,000 uninsured people are expected to be eligible for Medicaid expansion in Wayne County, said the Ann Arbor-based Center for Healthcare Research and Transformation in a January 2013 report. Another 85,000 are expected in Oakland, Macomb and Washtenaw counties, CHRT said.

Medicaid eligibility will now cover a single adult with annual income of $15,000 or less and families of four with annual income below $34,000.

Harbor expects to add members in several ways, said Berger, one of which is adding Harbor MIChild.

MIChild is Michigan's program for children of low-income working families that is part of the 17-year-old federal Children's Health Insurance Program.

Some 37,500 children under age 19 whose parents are not eligible for Medicaid receive health and dental coverage for about $10 per month per family.

Since Oct. 1, the Michigan Department of Community Health has been transitioning the MIChild program from Blue Cross Blue Shield of Michigan into Medicaid health plans as part of health care reform. Blue Cross continues to cover about 6,000 MIChild members, said Blue Cross.

Harbor Health Plan also hopes to pick up about 6,000 enrollees in Wayne County this spring from the state-funded adult benefit waivers program, currently administered through the Wayne County Four State Health plan.

Over the next few weeks, the estimated 35,000 adult beneficiaries with incomes lower than 35 percent of the federal poverty level in Wayne County are being shifted into the Medicaid program.

Those people will choose among eight Medicaid health plans in Wayne County, including Harbor Health, Midwest Health Plan, Meridian Health Plan, Molina Healthcare of Michigan, Blue Cross Complete and three other plans.

Jon Cotton, president and COO of Detroit-based Meridian Health Plan of Michigan, said Meridian, the state's largest Medicaid HMO with 290,000 members, could add up to 100,000 new members during the next year.

"We also started enrolling MIChild and already have 3,500 children," Kendall said. "They are considered commercial, and the fees are lower than Medicaid."

As part of its growth strategy, Harbor Health Plan will also add a Medicare Advantage product this year and apply to the Michigan Department of Community Health in 2015 to expand its Medicaid plan into Oakland County, Berger said.

"We have an incredibly big (physician) network," Berger said. "We have more than 400 primary care physicians in Wayne County and more than 3,000 specialty doctors."

While some experts have expressed concern that the nearly 1 million newly insured people in Michigan might have problems finding primary care providers, Berger said medical access won't be a problem.

"Everybody is worried about it, but I talk with a lot of physicians and they would like to be busier than they are right now, especially at Medicare rates," Berger said.

Under Medicaid expansion, physicians have been promised to be paid Medicare rates for at least the first two years.

Harbor Health is managed by DMC's accountable-care organization, Michigan Pioneer ACO. DMC has a contract with Medicare to coordinate care for about 15,000 Medicare fee-for-service patients.